Provider Demographics
NPI:1841494416
Name:HUSAIN, AMINA (MD)
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMINA
Other - Middle Name:
Other - Last Name:ZAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8370 PARAGON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2135
Mailing Address - Country:US
Mailing Address - Phone:937-223-9117
Mailing Address - Fax:937-496-3595
Practice Address - Street 1:20303 CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1073
Practice Address - Country:US
Practice Address - Phone:708-898-1858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35097337207W00000X
NC2008-00496207W00000X
IL036.148389207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2786593032OtherMYUTMB 2786593032-COMMERCIAL NUMBER
OH0054561Medicaid
2786593032OtherMYUTMB 2786593032-COMMERCIAL NUMBER